TY - JOUR
T1 - C5 Motor Palsy After Single- and Multi-level Anterior Cervical Diskectomy and Fusion
T2 - A Retrospective Review
AU - Wagner, Scott C.
AU - Sebastian, Arjun S.
AU - Butler, Joseph S.
AU - Kaye, Ian D.
AU - Morrissey, Patrick B.
AU - Hilibrand, Alan S.
AU - Vaccaro, Alexander R.
AU - Kepler, Christopher K.
N1 - Publisher Copyright:
© 2018 by the American Academy of Orthopaedic Surgeons.
PY - 2019/4/15
Y1 - 2019/4/15
N2 - Introduction: Postoperative C5 nerve root palsy is a known complication after cervical surgery. The effect of increasing number of levels fused on the prevalence of C5 palsy after anterior cervical diskectomy and fusion (ACDF) is unclear. Methods: Medical records of ACDF patients that included the C4-5 level at one institution were retrospectively reviewed. C5 palsy was defined as motor decline of the deltoid and/or biceps brachii muscle function by at least 1 level on standard manual muscle testing. Results: A total of 196 patients met the inclusion criteria, with no significant differences noted between groups undergoing single- or multi-level ACDF. The overall C5 palsy rate was 5.1%. Palsy rates were not statistically significant based on the number of levels fused. Six of the 10 patients with C5 palsy had complete recovery of motor strength, whereas 2 patients had at least some level of strength recovery. Conclusion: The overall C5 palsy rate was 5.1% for all patients undergoing up to four-level ACDF. The rate of postoperative motor decline was lowest in the patients undergoing two-level ACDF and highest in the single-level group, but this finding did not reach statistical significance. The prognosis for strength recovery by final follow-up is excellent.
AB - Introduction: Postoperative C5 nerve root palsy is a known complication after cervical surgery. The effect of increasing number of levels fused on the prevalence of C5 palsy after anterior cervical diskectomy and fusion (ACDF) is unclear. Methods: Medical records of ACDF patients that included the C4-5 level at one institution were retrospectively reviewed. C5 palsy was defined as motor decline of the deltoid and/or biceps brachii muscle function by at least 1 level on standard manual muscle testing. Results: A total of 196 patients met the inclusion criteria, with no significant differences noted between groups undergoing single- or multi-level ACDF. The overall C5 palsy rate was 5.1%. Palsy rates were not statistically significant based on the number of levels fused. Six of the 10 patients with C5 palsy had complete recovery of motor strength, whereas 2 patients had at least some level of strength recovery. Conclusion: The overall C5 palsy rate was 5.1% for all patients undergoing up to four-level ACDF. The rate of postoperative motor decline was lowest in the patients undergoing two-level ACDF and highest in the single-level group, but this finding did not reach statistical significance. The prognosis for strength recovery by final follow-up is excellent.
UR - http://www.scopus.com/inward/record.url?scp=85064509084&partnerID=8YFLogxK
U2 - 10.5435/JAAOS-D-17-00764
DO - 10.5435/JAAOS-D-17-00764
M3 - Review article
C2 - 30216246
AN - SCOPUS:85064509084
SN - 1067-151X
VL - 27
SP - E390-E394
JO - The Journal of the American Academy of Orthopaedic Surgeons
JF - The Journal of the American Academy of Orthopaedic Surgeons
IS - 8
ER -